De La Rosa, Jennifer Elizabeth

De La Rosa, Jennifer Elizabeth is an individual health care provider with primary practice located at 14515 Hamlin St , Van Nuys CA 91411-1686. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, which is considered as her primary health care specialty. De La Rosa, Jennifer Elizabeth can be contacted via phone (818) 989-7475.

Contact Information

Primary practice address
14515 Hamlin St Van Nuys CA 91411-1686
Phone: (818) 989-7475
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X

Profile Details

NPI number 1194359414
LBN Legal business name De La Rosa, Jennifer Elizabeth
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 25th, 2020
Last updated Mar 26th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194359414 NPPES
California MEDICAID 22540000X

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